My experiment: An interim report

Edited to add:  Well, judging by the comments received thus far,  some people need to attend a brief refresher course entitled ‘Recognising Irony’… ;o)   (Or perhaps i need a refresher course in ‘You’re Not Funny, Aethelread.  Give up the attempt’…)  For the absolute avoidance of doubt – if something in this post appears to be somewhat far-fetched, or an example of ‘over-reading’, you should consider the possibility that it is not intended to be taken seriously.  I find it interesting that so many of you should have assumed that I would have been thrown into a paranoid loop by this, to the extent that I would actually have a settled belief that a delayed letter would be malicious.  I mean what i say in the last-but-one paragraph – this is a relief.

As indicated in an earlier report, I am in the midst of conducting an experiment into the behaviour of Mental Health Services.  Further to the actions detailed in that report, I am pleased to be able to announce that the initial response of MH services has been as follows:

Letter received: 17.08.09

Postmark on envelope: 14.08.09

Date given on letter: 07.08.09

Dear Aethelread,

I am sorry you were unable to attend the outpatient clinic.

I would ask that you contact the clinic on the above number if you desire a rescheduled appointment.  If we have not heard from you within ten days of the date of this letter, we shall assume you no longer want contact with us.

Yours sincerely,

pp General Psychiatrist

This response corresponds closely with one of the anticipated responses as outlined in the initial report:

The ‘better make it look like we’re going through the motions’ response: the staff-grade general psychiatrist will contact Aethelread by letter, noting his failure to attend the appointment, inviting him to respond within a set period, and informing him that if he fails to respond within this time period he will be discharged back to his GP

Preliminary Analysis of Results

There are some notable features in this letter.  Perhaps the most obvious of these is the discrepancy in dates. The letter was not posted – second class – until Friday 14.08.09 (a full week after the date of the appointment); this means those despatching the letter knew full well that it would not be received until Monday 17.08.09, at the earliest.  Despite this, the letter is dated 07.08.09, and invites Aethelread to respond within 10 days of this date.

The letter was received by Aethelread at approximately 1400 (his post is always delivered late in the day), and the clinic stops taking calls at 1530.  The staff at the clinic have therefore arranged to give Aethelread a time window of approximately 90 minutes to contact them, but only because he happened to be in his flat at the time the mail was delivered.  Had he been out of the flat for some reason (or had the 2nd class post taken longer to deliver), he would have been presented with a fait accompli, in which his discharge would have taken place before he had been given an opportunity to request a rescheduled appointment.  It should be highlighted that MH services are unaware at this time if Aethelread has simply forgotten the appointment, perhaps as a result of an acute crisis in his illness, and that receipt of this letter might therefore constitute the first time he has been given an opportunity to think about the issue.

This is clearly an extraordinarily sophisticated example of the ‘better make it look like we’re going through the motions’ response.  In the event of an inquest occasioned by the discovery of Aethelread’s body dangling from a ligature secured to the branch of a tree (note: this will not, I guarantee, ever happen), General Psychiatrist and others will be able to claim that they had given Aethelread every reasonable opportunity to contact them, since the file copy of the letter contained in his medical records will, naturally, make no reference to the date the letter was actually posted.  However, by delaying the despatch of the letter they have effectively achieved the freedom of action they would have enjoyed under a ‘thank fuck for that’ response.  This is really very clever, and there is an extremely impressive level of ingenuity on display here.  (The patient, Aethelread, has noted that this is the first time that General Psychiatrist has given any indication of being in possession of such intelligence.)

There are other interesting aspects to the response.  The letter invites Aethelread to respond by telephone (and, as has already been noted, the timescales involved make any other means of contact wholly impractical), despite the fact that Aethelread’s reluctance to use this method of communication has been extensively discussed with more or less every MH professional he has come into contact with, and this antipathy has been fulsomely documented in his notes in order, in General Psychiatrist’s words, ‘that we know the right way to contact you’.  Aethelread has indicated that, at the time these words were used, he had assumed that this meant that the general would take care to contact Aethelread in the manner that was easiest for him.  He did not realise that this meant that his antipathy with regards to telephonic communication would be used as a means of facilitating the general’s efforts to get him to go away and keep quiet.

Another interesting aspect to the response is the first sentence of the letter.  The choice of language here – ‘you were unable to attend’ – [emphasis added] suggests that General Psychiatrist was fully cognizant of the likelihood that Aethelread’s non-attendance was a symptom of his MH problems, rather than a simple choice.  Despite this, the remainder of the letter makes no allowance for this, nor is there any indication that the general feels any professional concern for what the presence of such symptoms may imply about Aethelread’s state of health and general mental well-being.

A final report will be provided in due course, once it has been conclusively established that a full disengagement from MH services (after a period of more than 11 years in their occasional ‘care’) has been so rapidly accomplished.

So, that’s it – the end.

I am slightly apprehensive of the consequences of having ‘burned my boats’, so to speak, and concerned that from now on the responsibility for managing my illness rests solely on my shoulders, and that if I should trip or stumble there will be no one to pick me up, or to help me cope.  But on the whole, it has to be said, this just comes as a major relief.  Imagine – no more contact with stupid, smug, self-satisfied, patronising, insulting, ethically bankrupt little pricks who get off on playing power games with the poor, desperate folk who need their help.  It’s enough to send a person quite delirious with happiness.

And now, if you’ll excuse me, I’m off for a mug of Rooibos and a Cadbury’s miniroll.  Never let it be said that Aethelread doesn’t know how to par-tay…

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9 Responses to My experiment: An interim report

  1. NiroZ says:

    I’d be inclined to say the timing of this letter was a simple fuckup on the psychiartists part.

    Believing and acting as if everything was intentional, while great when writing english essays, isn’t a healthy way to work.

  2. Astrid says:

    That sounds rather stupid of the psychiatrist. Really, he should’ve sent the letter after he wrote it rather than having it sit around for a week. But then again, it doesn’t surprise me that htis shrink would act htis way, given your other post.

  3. Hanberry Pie says:

    UGH! sodding Mental Health Services, can we blow them all up please? perhaps we could use your recent letter as a taper to light the fuse?

  4. Lucy McGough says:

    I think that your letter was sent late by accident, and I think that ‘unable’ could imply a number of things – they might have thought you were physically ill, stuck in traffic, dealing with a family emergency, trying to mop up a flooded kitchen, etc.

    I really admire your intelligence, but sometimes I think maybe you read too much into things.

  5. cellar_door says:

    We always sent out a near identical letter when people didn’t show up for counselling in primary care. What usually happened was that the persons name would go on the big list of everyone else who hadn’t turned up so the secretary could do a load of letters at once. Then they would be sat on the secretaries desk until she remembered to post them. The counsellors knew this and never held anyone to the deadline.

    So I wouldn’t read too much into this, it really is just the general speed at which the NHS works, unfortunately…

  6. You know if you contact them late it won’t be too late. You can explain that you didn’t get the letter on time. They will understand.

    I’m sure it was a simple mistake. I know you want to be discharged, but I think it will be a mistake. You need some form of support. Even if you’re okay at the moment (which I’m not sure you are), there may come a time sooner or later that you really need some help and if you’re in the system it’s a lot easier to come by.

    I understand the logistics may be difficult for you. I understand your fear of the phone. I am terrible with it too. If that really is a problem that you can’t overcome perhaps you could send them a letter tomorrow. Explain that you only got the letter today, that you are scared of the phone but could they contact you with a new appointment. I think they’d oblige.

    I wouldn’t give up yet. xx

  7. Josie says:

    Interesting :)

    I agree with the above comments – you’ve probably read too much into it.

    The whole system is silly though. I couldn’t make it to an assessment at a CMT because i was too ill. I managed to phone up and say i couldn’t (which was impressive because i was a mess) and the nurse shouted at me. I was immediately discharged back to my GP. Cue absolute feeling of hopelessness and despair! Later that day my flatmate had to drive me to the GPs, unwashed and in my pyjamas (by this point the concept of walking 5 minutes round the corner to the surgery was beyond me). My GP was understandably rather unimpressed by that CMT!

  8. aethelreadtheunread says:

    Thanks for the comments. For those of you concerned that i am currently experiencing a paranoid meltdown, please see the big red addition at the top of the post. :o)

  9. Lucy McGough says:

    Okay, I clearly need a refund on my irony detector.

    But my comment about really admiring your intelligence still stands :-P

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